MEDICARE: KATE TODD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1902640378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE TODD

Provider Business Mailing Address
First Line	:	111 AMERSON ORCHARD RD APT 310
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-8571
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 ENGINEERING WAY
Second Line	:
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-0559
Country	:	US
Telephone Number	:	800-331-4331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2024
Last Update Date	:	05/13/2026

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Directions to “ KATE TODD ” Practice Location

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